在8月31日人身险产品利率切换时点即将来临之际，多位保险业内人士表示，重疾险价格也将迎来一轮 上涨。重疾险价格越来越贵，带来的是保险杠杆率下降，近年来这一现象持续显现，让消费者意兴阑 珊。同时，不少重疾险产品投保门槛颇高，比如一些年轻人因患有甲状腺结节等病症被拒之门外。在险 企一侧，重疾险赔付率走高、业务风险增大，叠加险企对储蓄险的押注，重疾险供给空间也受到挤压。 曾经在健康险领域扛大旗的重疾险，近几年经历了持续萎缩，让健康险整体增长乏力。同时，健康险内 部结构也在发生变化，杠杆率更高的医疗险逐步替代了重疾险的主流地位。 在健康险经历重构期以及政策鼓励健康险发展的背景下，业内人士认为，健康险需走出传统的纯保险保 障模式，同时加快从"保健康人"向"保人健康"转变，一张保单要涵盖专属保障、医疗服务、特色权益等 多个方面，发挥健康管理、支付创新、生态整合等价值，让市场供需更加适配、行业经营能力持续提 升。 ● 本报记者 薛瑾 杠杆率变化加剧内部分化 "前两年我想购买重疾险，因患有甲状腺结节，经纪人告诉我买不了，险企会拒保。最近几天又问了其 他保险中介，给出的答复依然是'不太好买'。中介说，如果切除结节后半年内未复发 ...

Core Insights - The rapid implementation of DRG/DIP payment reform and the normalization of drug procurement have led to a surge in demand for "out-of-hospital medication coverage" among patients [1][10] - Insurance companies are accelerating the iteration and upgrade of high-end medical insurance products, with "out-of-purchase drug responsibility" becoming a focal point of this product upgrade [1][4] Group 1: Market Dynamics - The out-of-purchase drug responsibility allows insurance companies to reimburse patients for medications purchased outside the hospital when necessary drugs are unavailable [2][3] - Major insurance companies like ZhongAn, Pacific Health, and Xinhua Insurance are launching innovative products to meet the urgent demand for advanced medications and special medical services [2][4] Group 2: Policy Impact - The DRG/DIP payment model has pressured hospitals to control costs, leading to cautious use of high-value original and imported drugs, pushing patients towards external purchasing channels [3][10] - The National Healthcare Security Administration has introduced measures to control unreasonable medical expenses, which has further influenced patient medication channels and cost-sharing models [2][7] Group 3: Product Innovation - Recent insurance products have incorporated out-of-purchase drug responsibilities, with companies like ZhongAn and Pacific Health offering comprehensive coverage without restrictions on disease types or medication lists [4][5] - Xinhua Insurance has made bold attempts in out-of-purchase drug responsibility, including a wide range of medications and specialized health management services [6][9] Group 4: Future Outlook - The collaboration between commercial insurance and basic medical insurance is crucial for developing a new payment ecosystem for innovative drugs [7][10] - The introduction of the "three exclusions" policy is expected to enhance the role of commercial insurance in covering high-value innovative drugs, providing a clearer boundary for insurance responsibilities [8][9]

Core Insights - The approval of over 20 innovative Class 1 drugs by the National Medical Products Administration in the first five months of this year marks a record high for the same period in the past five years [1] - The commercial health insurance sector is accelerating innovation to ensure that advanced medical services are accessible and affordable for consumers [1][2] - The market size for innovative drugs and medical devices in China is projected to reach 162 billion yuan in 2024, reflecting a 16% increase from 2023 [1] Group 1: Market Dynamics - The personal out-of-pocket expense for innovative drugs and devices remains high at 49%, while medical insurance fund expenditures account for approximately 44%, and commercial health insurance only covers about 7.7% [1] - The expansion of commercial insurance coverage for innovative drugs aligns with policy directives aimed at enhancing health insurance service levels [2] Group 2: Insurance Innovations - New insurance products, such as Xinhua Insurance's "Medical Worry-Free Insurance," are extending coverage to medications and medical devices purchased outside of hospitals, addressing patient needs for advanced medical resources [3] - Ant Group's insurance platform has upgraded its "Good Medical Insurance" series to include reimbursement for over 1,500 advanced drugs and devices, enhancing coverage for imported and original research drugs [3] Group 3: Payment Mechanisms - A multi-tiered payment mechanism has emerged, primarily driven by market-oriented commercial health insurance, which includes various types of insurance such as inclusive insurance, million medical insurance, and critical illness insurance [4] - The total compensation amount for innovative drugs and devices from commercial health insurance is estimated to be around 12.4 billion yuan in 2024, representing 7.7% of the innovative drug market size [4] Group 4: Challenges and Considerations - The introduction of new drugs and technologies presents challenges for insurance companies, as they may increase treatment costs and claims [5] - Insurance companies are focusing on balancing the coverage of advanced drugs while keeping premiums affordable to ensure product accessibility [5]

Core Viewpoint - Xinhua Insurance is committed to a "steady progress" approach, focusing on value and first-year premium business development, achieving significant growth in premium income and new business value in 2025 [1][7]. Group 1: Financial Performance - In the first five months of 2025, Xinhua Insurance achieved premium income of 99.086 billion yuan, a year-on-year increase of 26% [1]. - The total assets surpassed 1.75 trillion yuan in the first quarter, with premium, revenue, and net profit all maintaining double-digit year-on-year growth [1]. - The annualized total investment return rate for the first quarter was 5.7%, an increase of 1.1 percentage points year-on-year [1][7]. - New business value saw a substantial increase of 67.9% [1][7]. Group 2: Strategic Initiatives - Xinhua Insurance actively participates in the construction of a multi-level social security system, underwriting 20 welfare insurance projects in cities like Jiaozuo and Zhengzhou [2]. - The company has provided approximately 1.45 trillion yuan in insurance coverage to over 30,000 corporate clients [2]. - The second pillar annuity business of Xinhua Pension Company grew by 1.7 billion yuan, while the third pillar commercial annuity insurance balance reached 2.1 billion yuan, maintaining industry leadership [2]. Group 3: Customer-Centric Approach - Xinhua Insurance emphasizes a customer-centric strategy, enhancing product offerings and service capabilities [3][4]. - The company has launched new products such as "Medical Insurance Without Worries" to meet diverse healthcare needs [3]. - A comprehensive customer rights system has been upgraded, providing a wide range of services including health, wealth security, and family support [4]. Group 4: Organizational Development - The "XIN Plan" aims to create a comprehensive career growth scheme for agents, enhancing their service and insurance supply capabilities [5]. - The company has seen double-digit growth in premium income across its three major channels in the first quarter of 2025 [5]. Group 5: Future Outlook - Xinhua Insurance plans to continue high-quality development, aligning with national strategies and focusing on five major areas: large-scale products, market expansion, service enhancement, and significant investments [8][9].